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March 30, 2012 #4,423 Publisher-Barry Block, DPM, JD

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Article by MA Podiatrist Shows Effectiveness of Laser for Onychomycosis 

Nomir Medical Technologies, Inc., has announced that new data from its landmark pivotal onychomycosis trial first published in the peer-reviewed Journal of the American Podiatric Medical Association (JAPMA) has once again been published in this prestigious journal. The new paper, which reports on a 270-day onychomycosis clinical trial, offers further scientific support for using the Noveon lasers as an effective therapeutic treatment.

Dr. Adam Landsman

This paper (JAPMA 102(2): 169-171, 2012) authored by Adam Landsman, DPM, PhD and Alan Robbins, MD is the third in a series of peer-reviewed articles published in JAPMA about Nomir’s Noveon Laser. The first Noveon-related JAPMA paper surveyed the emerging field of laser treatments for podiatric infectious disease. The second paper presented the initial 180-day results of Nomir’s pivotal human clinical trial for the Noveon treating onychomycosis.

Magazine Recognizes CT Podiatrists as "Top Docs"

Connecticut Magazine recently sent more than 5,000 questionnaires to doctors from one end of Connecticut to the other, asking them to recommend a doctor (other than themselves) to whom they would send a loved one for expert medical care. The top vote-getters in the podiatry category were Drs. Peter Blume, James M. DeJesus, David Mader, Michael Z. Fein, Gary Grippo, and John J. McHugh. 

(L-R) Drs. Peter Blume, James M. DeJesus & David Mader, Michael Z. Fein, Gary Grippo, and John J. McHugh

Also named were podiatrists who finished at the top of the surveys from the years 2009 to 2011 (in alphabetical order):  Drs. Douglas A. Albreski, Marc R. Bernbach, David Caminear, Alan H. Feldman, Harris Greenberger, Robert E. Marra, Robert P. Matusz, David C. Novicki, Andrew Rice, Ashley Shepard, Eric Silverstein, and Abraham C. Yale.

Source: Connecticut Magazine [April 2011]

CASPR Match Results to Be Released on April 5, 2012

The American Association of Colleges of Podiatric Medicine (AACPM) and the Council of Teaching Hospitals (COTH) have announced that the 2012 CASPR Match results will be available on Thursday, April 5th at 11am Eastern Time. 

CASPR

Students and residency programs can log on to CASPRweb.org and click on the Match tab under their account. 

MI Podiatrist Sentenced to One Year in Prison for Medicare Fraud

Dr. Errol Sherman, a Detroit-area doctor of podiatric medicine was sentenced today to one year in prison for a fraud scheme involving false billings to Medicare, announced the Department of Justice, the FBI and the Department of Health and Human Services (HHS). In addition to his prison term, Sherman was sentenced to three years of supervised release and ordered to pay $300,000 in restitution. According to the plea documents, between January 2003 and December 2006, Sherman billed Medicare and Blue Cross Blue Shield of Michigan for a procedure known as an avulsion of the nail plate or nail avulsion procedure. Sherman billed for this procedure thousands of times, claiming that he had performed this procedure on hundreds of beneficiaries from 2003 through 2006. In fact, he had not performed the procedures billed.

Source: U.S. Department of Justice

MGMA-ACMPE Reports Academic Doc Pay for 2011

The median compensation for a primary-care faculty member in the U.S. was $167,943 in 2011, while median compensation for a specialty-care faculty member was $253,917, according to a report from the MGMA-ACMPE, formerly the Medical Group Management Association. The MGMA-ACMPE's report also notes that specialists in academic settings are paid less than those in private practice.

The report, The Academic Practice Compensation and Production Survey for Faculty and Management: 2012 Report Based on 2011 Data, found that among selected academic clinical specialists, orthopedic surgery faculty members had the highest median compensation, at $432,260. Faculty members specializing in endocrinology/metabolism were at the low end of the compensation scale, at $161,337, according to the report.

Source: Paul Barr, Modern Physician [3/28/12]

Query: Patient Satisfaction Surveys
 
I am putting together a patient satisfaction survey for my offices and would like some assistance. I want it for the purpose of evaluating the office staff (both medical and clerical), as well as the office itself. I would appreciate any suggestions as to the questions to ask, the proper wording of the question, and if any templates are available.

Charles Morelli, DPM, Mamaroneck, NY

RE: Del Priore Insurance Services (Barry Finkelstein, DPM)
From: Cindy Del Priore, MBA

I'm an independent insurance agent and represent Medical Protective for podiatrists in New Jersey, Pennsylvania & New York. Medical Protective, medpro.com  (rated A++ by A.M. Best) writes podiatrists through their RRG ONLY in New York due to the unique climate in New York State. Medical Protective formed the RRG to write medical doctors in New York a few years ago, and recently added podiatry as a specialty. Many risk retention groups have formed within the past 5 years to write medical doctors in NY to take advantage of the marketplace where there were only 2 admitted insurance carriers (MLMIC and PRI.)
 
Medical Protective writes podiatrists now across the country, but only in NY through the RRG. They are the largest malpractice carrier in the country and have been in business for 110 years.  I would not normally recommend RRGs myself, but this is 100% re-insured and operated by Medical Protective, and therefore is very stable. 
 
Cindy Del Priore, MBA, Del Priore Insurance Services, c.delpriore@delprioreinsurancesvcs.com

RE: Diagnostic Ultrasound Workshop? (Jim Petko, DPM)
From: James R. Christina, DPM

Attendees at APMA’s Annual Scientific Meeting (The National) in Washington, DC, have the option to register for a pre-conference, hands-on ultrasound workshop presented by the American College of Foot & Ankle Orthopedics & Medicine. The workshop takes place on Wednesday, August 15, from 12 to 4 P.M. and offers 3.5 contact hours of CME credit in addition to the 26.5 hours available at The National. For more information or to register, visit apma.org/thenational to check out our Preliminary Program.
 
James R. Christina, DPM, Director of Scientific Affairs, APMA, JRChristina@apma.org

RE: Recommendations for EMR/EHR (Elliot Udell, DPM)
From: Al Musella, DPM, Michael L. Brody, DPM
 
I am a Practice Fusion user also. I am pretty happy with it, but there is a big problem with Dr Udell's 5th point:  "5) Minimal loss, if the company providing the EMR system should go out of business or be bought out by another company whose intentions are to sunset the program and sell you a new one."

I just talked to Practice Fusion to confirm this: there is no way for us to download the data in any format. They say that IF we leave Practice Fusion, they will send us a DVD with our data on it, but we cannot get that data unless we quit Practice Fusion. I asked if they plan on implemented a way to download the data in the future, and they said no. IF they go out of business, or have a bad data loss, we are all stuck.
 
Al Musella, DPM, Hewlett, NY, Musella@aol.com

I need to take exception to Dr. Udell's statement on the minimal loss if Practice Fusion ceases to exist. My comments are not specific to this particular program, but are appropriate to all online EMR providers.

If you use an online EMR provider and they go out of business, it is possible that you will lose access to your medical records. That loss is much, much more than the loss associated with having to purchase a new EMR.

Michael L. Brody, DPM, Commack, NY, mbrody@tldsystems.com

RE: Recommendations for EMR/EHR (Greg Caringi, DPM)
From: Pete Harvey, DPM

I have been happy with MDsuite. Support has been excellent. We have used the MDsuite predecessor, Elligence for many years. Integrated with the program is an appointment scheduler, capture for claim submission at the end of the day, highly usable demographic screens, and the ability to capture all reports as needed. The EHR is not podiatry-specific, but the models are thereby easy to customize by the staff or the doctor. eRx is integrated with the program to send prescriptions automatically to the pharmacy. Before completing the patient encounter, the doctor can check a box to automatically send a report to the referring physician. I use Dragon Medical for patients who do not easily fit a model.  We met incentive qualifications last year with the program, and will do so again at the beginning of 2013.

Pete Harvey, DPM, Wichita Falls, TX, pmh@wffeet.com

RE: Taking X-Rays on Patients with Ingrown Nails (Tony Poggio, DPM)
From: Barry Mullen, DPM

Subungual exostoses are not rare, though not every pincer nail can be ascribed to one. So, how does one differentiate and become suspicious of their presence when a patient presents with a painful ingrown toenail? The key is the exact location of the patient's maximum pain relative to the nail folds. One must be very specific how one palpates the toenail in order to distinguish between the two. Ingrown toenails are usually maximally painful to palpation along the disto-medial/lateral nail folds, while subungual exostosis pain is generally centrally located just proximal to the distal nail fold.

The exception occurs when an underlying subungual exostosis or bone tumor is eccentrically located (discovered via D/P x-ray). If a symptomatic pincer nail's maximum palpable pain is centrally located, a D/P and isolated hallux lateral x-ray image is most certainly warranted to rule out the suspected underlying osseous pathology because its presence totally changes the treatment course.

Osteochondromas are much more frequent in children and have cartilage caps, so their visualization on x-ray can be missed, or grossly underestimated, though much less so with the newer, higher resolution digital x-ray machines.
 
Barry Mullen, DPM, Hackettstown, NJ, yazy630@aol.com

RE: CA Sports Podiatrist Discusses Injury to Yankees Pitcher
From: Frank Lattarulo, DPM

Thankfully, the initial reports were wrong (if you're a Yankee fan that is). In an interview with Yankee beat writers, Joba described his injury in detail. It was "only" a dislocation of his talus (his own words). There was no compound fracture and no laceration of the PT artery which I assume was the artery that was reportedly severed that caused 'life threatening blood loss." Again, good news if you are a Yankee fan. For my colleagues up in Boston, well not such good news.

Frank Lattarulo, DPM, NY, NY, doclatt@aol.com

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